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Death Saves Revived

thinkdm Changing the Rules, DM Tips, Homebrew, The Simple Things
August 1, 2020August 8, 2020
When D&D went to 5th Edition, they dropped the notion of negative hit points and came up
with a new system called “death saving throws.”

Death Save Mechanics

Under this system, when you reach 0 HP, you fall unconscious and you begin making
“death saving throws.” Each death save is a DC 10 check (no modifiers). It’s set up in a best-
of-5 system. So, if you get 3 successes, you live; if you get 3 failures, you die. A creature who
lives is stable at 0 hit points and needs time to recover. There’s an interesting little mechanic
that instantly revives you with 1 HP when you roll a 20, and an opposite mechanic that
gives you two death saves when you roll a 1. If you get hit, you lose 1 death save; criticals
count as 2 hits.
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There was also a set of rules in Tomb of Annihilation called “Meat Grinder Mode”
(https://thinkdm.org/2018/08/11/meat-grinder-death-saves/) that set the death save DC
to 15. This drops your survival odds from 60% to 26%
(https://thinkdm.org/2018/08/11/meat-grinder-death-saves/)!
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Without getting into the minutiae, I submit that this is an improved system over negative
HP. But, that doesn’t mean it’s perfect. What are some places we could improve the death
saves system?

Being Unconscious
Being unconscious sucks in 5th Edition. It imposes a host of debilitating effects that render
your character exceptionally vulnerable and useless during your turn (except for the
opportunity to make a death save).
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Being unconscious leaves you prone, which is a mixed bag of mostly bad tricks.

Being unconscious also imparts the incapacitated condition, which prevents you from
taking actions or reactions.

These effects combine to create a system that is not very narratively satisfying on either side
of the blade.

The Fallen
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From the perspective of the fallen creature, they have been taken out of the game. They need
to wait around for their turn to come around, and then all they can do is roll and pass. Even
if they stabilize at 0 HP, they cannot make any difference in combat.

It would be more narratively satisfying if they could do something, even in a limited

capacity. Crawl the last 5 feet towards the Big Red Button, utter your dying words, warn
your allies, etc.

This would also give the baddies a reason to target fallen PCs, instead of forcing the DM to
make the tough choice between breaking narrative to spare your character or being ruthless.
The latter often feels like it’s being done by the DM and not the forces of evil.

Note: While I know not all foes will target a downed PC, it’s a reasonable tactic for any intelligent
creature in a world with ubiquitous healing. To test this theory, add death saves and healing word to
your monster stat blocks and see how the players respond. For better monster tactics, check out Keith
Ammann’s work, The Monsters Know What They’re Doing (https://www.themonstersknow.com/).

The Coup de Grâce

The coup de grâce mechanic is a little odd, due to the interaction of a few rules:

You still need to roll to hit a lifeless creature.

But, you deal a critical hit when you do it.
Close attacks against you are made with advantage.
But, attacks at range are made normally. They would be made at disadvantage because
you’re prone; they would be made at advantage because you can’t see.

This doesn’t fit with the way most people think this mechanic should be handled. In fact,
less than 19% of players think that attacking an unconscious creature should follow this
system:
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Instead of attacking how the unconscious condition works, perhaps we can disguise its role
in the death saves paradigm with a more clever mechanic. Players will be more satisfied
with losing out on their desired auto-crit if the narrative supports that the fallen PC is still in
the game.

The Fix
Our solution is a progressive mechanic that uses all the same conditions, but imposes them
with increasing level of severity. This adds additional drama to each death save not only
due to the threat of dying, but due to the threat of not being able to help your party (and
therefore yourself).

0 Failed Death Saves: Prone (Cannot Stand)

1 Failed Death Save: Incapacitated
3 Failed Death Saves: Dead
More Fails than Saves: Unconscious
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Falling prone at zero HP signals that you do not have any more energy to fight. You have
collapsed from the toll the battle has taken on you. While you cannot stand, your speed does
not become 0, so you can still crawl around and take actions and make attacks at
disadvantage in a last-ditch effort to defend yourself from the onslaught of death. You may
also want to have casters drop concentration at zero HP.

On your first failed save, you become incapacitated. You have lost the power to fight. You
can no longer impact the battle in a meaningful way, but you can still crawl around, grab
McGuffins, and tell your teammates how you really feel about them before your dying
breath.

Any time you have more failed death saves than successful saves, you are unconscious.
Your unresponsiveness serves as a mechanical signal to your team that you’re not doing so
hot, whereas under the current system they have no idea how many death saves you’ve
passed or failed without metagaming. This also adds additional drama to each roll, since
you can slip in and out of consciousness. Imagine you’ve fallen unconscious, and you revive
with one last gasp of air to take your final act. On the flip side of the narrative, bad guys
now have a legitimate reason to ignore an unconscious creature, who is surely slipping
towards death, compared with the usual 60% survival rate for a creature in death saves.

Once you roll three successes, you’re stuck with whatever conditions you had while you
were in death saves (since the system can’t let you end unconscious, as per RAW). Imagine
how this would lead to dramatic results, like the last living party member crawling back to
town.

If you want some more death saves hacks, check out our alternative Meat Grinder Mode
suggestions (https://thinkdm.org/2018/08/11/meat-grinder-death-saves/). Support us on the
ThinkDM Patreon (https://www.patreon.com/ThinkDM), where you can get additional
content, early releases, and personalized help on your own design!

Tagged:
5e,
5th Edition,
Blinded,
Coup de Grace,
D&D,
Death Saves,
Death Saving Throws,
dnd,
Dungeons & Dragons,
Incapaciated,
McGuffin,
Meat Grinder,
Player's Handbook,
Prone,
Tomb of Annihilation,
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 Unconscious

14 thoughts on “Death Saves Revived”

Mr. Brown says:

August 1, 2020 at 4:23 pm
Here are my crunchy Death Save rules

0 HP – Automatically fall Prone, gain one level of Exhaustion. Cannot take reactions.

1st Success: Can move or take one action or bonus action

2nd Success: Can move and take one action or bonus action
3rd Success: Gain 1 Hit Point if no Failures, otherwise fall Unconscious and stabilize at 0
hp

1st Failure: Stunned until beginning of next turn

2nd Failure: Fall Prone and gain another level of Exhaustion if at least one Success,
otherwise Unconscious
3rd Failure: Dead if no Successes, Prone & Stunned if at least one Success, healing magic
does not work, dies in one minute

Reply
mudanimal says:
August 2, 2020 at 2:58 pm
I’m curious. On a first successful death save using this, would you allow the PC to
use the Dash action (increase movement by amount equal to their speed, usually
doubling movement) to get up and move? Or is it an exclusive choice between
moving and the action? I’m also imagining using misty step to teleport away, since it
costs half speed to stand up while prone. Pretty interesting house rules!

Reply
mudanimal says:
August 2, 2020 at 1:41 am
An interesting point on what you mentioned about the unconscious creature not being
able to see: the 5e unconscious condition actually doesn’t list the creature being blind –
just “unaware.” (I would personally run it as if they’re blind.) What it does list is that
attacks against the unconscious creature are made at advantage.

The prone condition lists that attacks made within 5 feet are at advantage – regardless of
melee or ranged. And ranged attacks are only at disadvantage if there are hostile
creatures (that aren’t incapacitated) within 5 feet of the ranged attacker or if the attacker
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 is beyond 5 feet of the target. So if that ranged attacker moves within 5 feet of the lone
unconscious creature, they’ll actually be attacking with advantage! Otherwise, it’ll be a
regular roll beyond 5 feet.

I just learned this today, by the way. Lol

Reply
Caleb says:
August 30, 2020 at 4:39 pm
I didn’t realize those rules interacted that way! Makes perfect sense though. Thanks
for pointing that out!

Reply
DDOCentral says:
August 4, 2020 at 3:46 pm
Reblogged this on DDOCentral.

Reply
Frederick Coen says:
August 10, 2020 at 1:51 pm
This is an interesting idea, as is Mr. Brown’s. My campaign imposes “hit 0 HP, gain a
level of Exhaustion”, and uses hidden Death Saves; otherwise the rules are RAW. Oh, but
one external rule – I use both a “Luck Point” (short term, 1 bonus roll), and a “Fate
Point” (one per level, auto-succeed one roll) mechanic. A Luck Point will cancel a failed
Death Save – it does not make the roll a success, though. A Fate Point will allow you to
act at Death’s Door (you are still at 0 HP, but functional — but with that level of
Exhaustion).

The big thing is that a mobile/functioning target is just that: a TARGET. These
suggestions mean the PCs remain valid targets. They will be attacked and killed.
Anything with multiattack will kill your character in a single round – maybe two, by
quickly inflicting 2 or 3 “failed Death Saves”, because you were still a threat. *especially*
if that prone PC is casting spells or attacking!

Reply
Meek Barbarian says:
August 13, 2020 at 11:47 pm
I really enjoyed this article. I’m actually looking forward to trying these at the table the
next time I DM.

Reply
Teo says:
August 21, 2020 at 1:18 pm
The issue I see is this makes it really hard to ever down a paladin or healer as they can
just use their first turn to heal themselves. Or really anyone who has a healing potion.
This makes going down less scary especially if it is the healer as the players would be
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 able to assume they could heal themselves most of the time.

Making it so they can’t use spells on themselves would be a weird addition to the rules.

I like the idea of them being able to crawl or to use an object in the world. It just is a hard
balance. It is fairly hard to die in 5e and while the knock out mechanic is boring it does
work to make things more intense.

Good article though.

Reply
thinkdm says:
August 25, 2020 at 8:30 am
Remember that you need to pass your first death save at the beginning of your first
turn. So you won’t be guaranteed to heal yourself. To me, that imparts an interesting
calculus for the attacker, who can decide to coup de gras or deal with more imminent
threats.

Action restrictions are totally valid, though. My goal was just to get you thinking
about how to improve if for your own game.

Thank you for your comment!

Reply
Frederick Coen says:
August 25, 2020 at 8:36 am
My thought was to (a) only remove 2 levels of exhaustion when restored to 1+ HP,
and clarify that taking an action while at 0 HP requires a Death Save *EVEN IF THAT
ACTION HEALS YOU*. So while the paladin can get himself back in working order,
he might still acquire that last Death Point doing so, and fall over dead.

Reply
Caleb says:
August 30, 2020 at 4:44 pm
Ah, so a risk-reward mechanic. Interesting! Another way to help limit action
abuse could be to require a successful DC 10 or 15 Consitution saving throw in
order to take an action.

Caleb says:
August 30, 2020 at 4:46 pm
This is quite brilliant! It definitely needs a bit of polishing as pointed out by other
comments as to not make characters even more resilient than they already are, but this
could tremendously increase the drama involved with dying. I’m going to have to try
this out!

Reply
Abelhawk says:
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 October 15, 2020 at 5:35 pm
I love these rules! I think the only change I would make is requiring another death
saving throw immediately before taking an action on your turn, if you choose to. Doing
anything except crawling away risks killing you outright if you roll a 1 after you already
have 1 failure.
As for coup de grace, I think I would only allow an automatic hit and kill if there were
no other combatants around. I still think there should be a chance of failing if there are
other enemies around stressing you out and getting in your way.

Reply
Abelhawk says:
October 15, 2020 at 5:38 pm
Also, I’ve recently implemented lingering injuries whenever you drop to 0 hit points,
which has been great. Getting that close to death should be a heck of an ordeal.

Reply

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